How necessary is the gestational diabetes test?

[Jac]

You know what's funny, I have to provide a urine sample for each visit to the OB and I admit that I'm not exactly sure what they're testing for! I thought it had someting to do with blood pressure/ketones in urine but now I will have to ask and see. I'm sure someone else will know though.

[Stars69]

Um I do the urine tests as well and never had glucose show, yet I have GD. I eat well, have not put much weight on etc.

The diabetes educator advised that sometimes there are NO external symptoms that you may notice. There are risk factors, being over 30, being overweight, genetic history etc that come into play but if you don't have the test and you do have GD, there is a liklihood that the baby will need to go into the special care nursery after birth to help it cope with all the extra work it has had to do producing insulin with the mothere's higher sugar level.

Your choice of course, but I would rather be uncomfortable for a little while than to run the risk of anything happening down the track.

[paradise lost]

That's interesting Stars, do you have anything in your urine that shouldn't (sounds a bit dodgy! LOL)? My middies definitely told me they only do the test if you have glucose because if you don't have glucose there you don't require treatment (i think they said sub or pre diabetic, can't remember). Like people can come up positive for the test when it's very temporary (because you SHOULD have more sugar in your blood while PG, to feed the baby, or something, and you can have more some times than others). But if there's no glucose that indicates it's within normal-for-you levels.

The testing here goes: glucose in urine? If yes then blood test. Glucose in blood high? If yes then glucose tolerance test. Glucose tolerance low? If yes then diagnose GD and treat. This is standard practice in the UK, so it's interesting to me. Hope you don't mind talking about it!

Bx

[*Belle*]

I was overweight in my first pregnancy and had the 2 hour GTT, came back normal, so weight gain is not and indicator. This time I only had the screening test and came back normal too, its possible for anyone can get GD, however must say it does depend on what you eat during pregnancy a little bit, if you eat sugar all the time the likely hood of getting GD is a bit higher.

I couldnt even compare the GTT test with the Step B, Step B is very dangerous and if you end up having it and give birth vaginally it is a worse danger to the newborn than not taking the ABs.

ETA my glucose level came back as 4 very low and im oveweight.

[paradise lost]

*Belle* i think people are comparing the 2 tests because like GD, a +ve result doesn't mean much. One study read found that about 80% of women who had StrepB at 34 weeks no longer had it at term and 30% who didn't have it at 34 weeks DID have it at term. It's not that strep B isn't harmful, or that GD isn't, it's that the TEST is unreliable even as a diagnostic tool.

Bx

[sasha]

One study read found that about 80% of women who had StrepB at 34 weeks no longer had it at term and 30% who didn't have it at 34 weeks DID have it at term.
Bx

Yes, that's my reasons for not taking the Strep B test. Besides, I have complete faith in the care I receive at the Birth Centre; I trust their decades of experience as well as their ability to help me make an informed decision about any test or disease which could affect me or my baby.

[*Belle*]

Yes, that's my reasons for not taking the Strep B test. Besides, I have complete faith in the care I receive at the Birth Centre; I trust their decades of experience as well as their ability to help me make an informed decision about any test or disease which could affect me or my baby.

i know this is off topic, but im sorry but no birth centre or hospital can guarantee any affects on your baby whether or not you take the test, the healthiness of the baby is up to you and your body and the baby, I understand not taking the test at 34 weeks and hope for the best (maybe they should do the test later, my OB does them at 36-37 weeks) totally your decision. Foe me I thought the test was easier than the pap smear and better to be safe and know as the antibiotics will be less harmful than if the baby actually got Step B while giving birth.

[~mamaspice~]

My advice would be for the sake of a couple of hours of your time and a little discompfort to you, it's not worth taking the risk by skipping the test. Better to be safe than sorry.
My SIL had GD and she was otherise healthy and certainly NOT overweight (a size 6-8)
I, on the other hand ,am overweight and didn't have gestational diabetes at all.

[mountain mummy]

I am small built, not overweight and have failed the GD test with all of my pregnancies so far - I am still waiting on the results of this one. But I also have a history of polyhydramnios and large babies, which wouldn't have been discovered the first time if I hadn't have failed the glucose test. Because of being very borderline with the test, I was sent for more ultrasounds to try to determine the cause. Although not officially diagnosed with GD, I am considered borderline and somewhat at risk.

Also, because of a history of thrombocytopenia, I have to have regular full blood counts anyway, so the glucose test was no biggie ....

But like everyone else has said, it is ultimately your choice (like I choose not to have the down syndrome testing done at 12 weeks)

If you feel it is totally unnecessary, then talk it over with your docs and midwives.

[fionas]

I was a bit overweight when I got pregnant but only put on 6kg during pregnancy, so weight gain is kind of neither here nor there. But my age also put me at risk.

I can't comment on how reliable the actual test was but my results were borderline.

Down the track, knowing this actually helped a bit because DD was a biggish baby (8lb 10oz) but is now an average-sized baby. I've been told her big size at birth was probably down to the fact that I was borderline GD so that eased my mind a little when she was not gaining as much as might have been expected when she was a newborn.

[Jac]

Can you have a smallish baby (ie. 6 1/2 pounds or less at full term) and still have GD or does a diagnosis of GD always result in a bigger baby?

[amberj]

Gee I wish I had read this thread before my GD test! I really did not want to have it, but just did because it seemed the done thing.

If you do decide to have it, is not pleasant, but its not the worse thing ever. It was funny though, I was on like this sugar rush high in the path waiting room after the drink. I could hardly sit still!!

BTW, my results were fine,.

[melbel]

Jac yes you could have a small baby and still have GD...the two dont necessarily go together. ANd Belle I have to say that what you say about what you eat causing GD is just so wrong it is not funny. Eating too much sugar does not cause diabetes of any kind full stop! It is far more complex than that.

Yes the test can give false positives, yes you can have GD and or elevated bloos sugar levels and not have sugar spill over into the urine as that is dependent on how well your kidneys are flushing the excess sugar out and also how well your body is at converting the extra suagr to glycogen stores.
I say it is better to be safe than sorry with this particular test. Even if you were to get a false positive the worst case scenario for first stage of treatment is that your diet would be modified and you would be asked to do some finger ***** blood tests a few times a day. If it was a false positive test your finger ***** tests over the course of a week or two will show this as if it is not truw GD they will fall within a normal range and the docs will quickly be able to see that things are okay.
The danger in ignoring gestational Diabetes has not a lot to do with the baby actually - it has everything to do with permanent damage to the islet cells of the pancreas - your pancreas. If they are overly stressed and it is left untreated permanent damage can occur. Statistically speaking 50% of people who have Gestational Diabetes and Do Not treat it will develop Type II Diabetes within 2 years. For those that do treat their GD and lessen the stress on the pancreas the outcomes are much better with less the 20% going on to develop Type II over the long term.
There ia a lot of controversy as to whether treating GD affects birthing outcomes for the baby (i.e. baby size, induction etc...) and I do not want to enter that debate

What I want to emphasise is that really the issue is so much bigger than just the pregnancy.....you need to think of it is a warning sign about the potential of long term damage to your own body not just how it affects the baby you are growing.

[snowchickie79]

I had my 1 hour GTT last week and got a 8.2 (anything over 7.8 you go for the 2hour test). Went for 2 hour test and got 9.2. I have GD.

I've always been slim, never overweight, no history of diabetes in my family, I am Australian so do not fall into a risk ethnic group and I'm under 30. I've been given an eating plan and the foods on it i ALREADY eat which is strange, but it can also come down to serving size and ultimately it is to do with insulin production. Some people's body apparently just can't keep up no matter your shape, size, history etc.

Just goes to show you that even healthy eating (I do not eat sweets or junk food and didn't before or during PG), you are still at risk of GD.

[SallyJ]

My very slim, very healthy vegetarian friend had GD with her first pregnancy, she was able to manage it with diet but had to be very very careful. She had no other indicators. (luckily she didn't have it with her second pregnancy).

Another friend, who's also slim and healthy, had it with her last pregnancy, she had to have insulin. She was over 40 though.

I would have the test. I know that it seems sometimes they are "over testing", but so many of them have saved lives that it is worth having.